Favara, Blaise Emile

Favara, Blaise Emile is an individual health care provider with primary practice located at 1114 W Main South Valley Pediatrics, Hamilton MT 59840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Favara, Blaise Emile can be contacted via phone (406) 363-5013.

Contact Information

Primary practice address
1114 W Main South Valley Pediatrics Hamilton MT 59840
Phone: (406) 363-5013
Fax: (406) 363-3714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MT7843 Montana

Profile Details

NPI number 1386637676
LBN Legal business name Favara, Blaise Emile
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Sep 26th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386637676 NPPES
Other 10341 BCBS
MEDICAID 0100487 BCBS

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